Provider Demographics
NPI:1972018901
Name:FRANCIS, LARAMIE (ATC)
Entity Type:Individual
Prefix:
First Name:LARAMIE
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BROOKHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-5437
Mailing Address - Country:US
Mailing Address - Phone:843-410-9428
Mailing Address - Fax:
Practice Address - Street 1:123 BROOKHAVEN RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-5437
Practice Address - Country:US
Practice Address - Phone:843-410-9428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer